Use of a HIV derived accessory protein for the reactivation of latent HIV

ABSTRACT

The present invention concerns the use of a protein comprising at least a HIV-derived accessory protein tat (trans-activator of transcription) or any derivative thereof for the reactivation of latent human immunodeficiency virus (HIV) from cells present in a HIV-infected patient.

The present invention relates to the use of a protein comprising at least a HIV-derived accessory protein tat (trans-activator of transcription) or any derivative thereof for the reactivation of latent human immunodeficiency virus (HIV) from cells in an HIV-infected individual.

Highly active antiretroviral therapy (HAART) can suppress HIV-1 levels in plasma to below the limit of detection of clinical assays (<50 copies/ml) and reduce the morbidity and mortality of HIV-1 infection. However, HAART alone fails to cure HIV infection. In particular, HAART leaves latent integrated proviruses unaffected. Latent viral genomes reside in a small pool of infected resting memory CD4+ T-cells that constitute a stable viral reservoir. In these cells, the provirus remains transcriptionally silent as long as the host cells are in a quiescent state. This allows the virus to evade host immune surveillance and rebound quickly following discontinuation of HAART. The remarkable stability of the latent viral reservoir necessitates lifelong HAART. Given the potential for toxicity and resistance, elimination of the latent reservoir has been proposed as a goal worthy of a major scientific effort.

Therapies targeting the latent reservoir generally involve reactivation of latent virus. Expression of viral genes renders infected cells susceptible to viral cytopathic effects and immune clearance. Along with HAART, this reactivation strategy could ultimately purge latent virus from infected individuals. While latent viruses respond to T-cell activation signals initial attempts to deplete the latent reservoir through T-cell reception (TCR) stimulation using anti-CD3 antibodies proved toxic. The toxicity likely resulted from global T-cell activation with subsequent release of pro-inflammatory cytokines. Therefore, an ideal treatment should reactivate latent HIV-1, but avoid overall T-cell activation.

However, despite global extensive research efforts, there still exists a high unmet medical need for reliable, safe and convenient compounds able to reactivate latent HIV from above mentioned reservoir in HIV-infected patients.

The current invention aims to using a mutant of the HIV-derived accessory protein tat (trans-activator of transcription) for the reactivation and subsequent eradication of latent HIV. The full length tat protein [86-101 aa] is translated from two different exons where exon-1 [1-72 aa] contains all domains essential for trans-activation. Mutagenesis experiments surprisingly identified the first 57 N-terminal amino acids of wild type tat as minimal reactivation domain (Table 2). The 66 amino acid deletion mutant [T66] with a reactivation capacity close to full length exon 1 Tat72 (Table 2) potently activates HIV in latently infected cell lines (Table 3) and primary CD4 cells (Table 4). The activity of Tat derivatives was evaluated ex vivo on patient-derived latently infected CD4 cells and compared with the most potent reference compounds known to reactivate latent HIV in vitro and ex vivo. Unexpectedly Tat 66 protein induced HIV activation and exceeded by far the reactivation achieved by reference compounds such as PHA (Phytohaemagglutinin), PMA (Phorbol myristate acetate), and SAHA (suberoyl anilide hydroxamic acid). The inclusion of a tat-derived protein in a treatment regimen will be essential to cure HIV infected people.

The current invention thus relates to the use of a protein comprising at least a HIV-derived accessory protein tat (trans-activator of transcription) or any derivative thereof for the reactivation of latent human immunodeficiency virus (HIV) from cells present in a HIV-infected patient.

Alternatively it can be expressed that the invention concerns a method of reactivating latent HIV present in a host cell by exposing a HIV infected cell with a HIV-derived accessory protein tat (trans-activator of transcription) or any derivative thereof.

Tat stands for, as mentioned above, “Trans-Activator of Transcription” and Tat consists of between 86 and 101 amino acids depending on the subtype.

Also, in molecular biology, tat is a protein which is encoded for by the tat gene in HIV-1. Tat is a regulatory protein that drastically enhances the efficiency of viral transcription.

Preferably said protein comprises at least a wild-type HIV-derived accessory protein tat for the reactivation of latent HIV but more preferably said protein comprises at least the first 57 N-terminal amino acids of wild-type tat (86-101 aa) for the reactivation of latent HIV.

Said protein may also comprise at least the first 60 N-terminal amino acids of wild-type tat (86-101 aa) for the reactivation of latent HIV.

Said 57 amino acids are represented by the following SEQ ID No. 1: MEPVDPRLEPWKHPGSQPKTACTNCYCKKCCFHCQVCFMTKALGISYGRKKRR QRRR.

The mentioned 60 amino acids are represented by the following SEQ ID No; 2: MEPVDPRLEPWKHPGSQPKTACTNCYCKKCCFHCQVCFMTKALGISYGRKKRR QRRRAHQ

The 66 amino acid deletion mutant [T66] according to the invention with a reactivation capacity close to full length exon 1 Tat72 has the amino acid sequence of SEQ ID NO 3:

MEPVDPRLEPWKHPGSQPKTACTNCYCKKCCFHCQVCFMTKALGISYGRK KRRQRRRAHQNSQTHQ.

In Table 1 below substitutions are provided for each position in these SEQ ID NO: 1, 2 and 3 respectively which are feasible in order to obtain a protein falling within the scope of the present invention.

TABLE 1 Primary T66 amino acid sequence with indicated substitutions No T66 Substitutions  1. M  2. E D  3. P L  4. V I  5. D N  6. P H  7. R N/S/K  8. L I  9. E D 10. P 11. W 12. K N/E/Q/H 13. H Q/R 14. P S 15. G 16. S 17. Q R/K 18. P 19. K R/T/A/I/S/Q/N/E/G/P 20. T 21. A P/D/N/E/S 22. C 23. T N/S 24. N K/P/T/S/A/Q/R/G 25. C 26. Y F 27. C 28. K 29. K R/H/A/M/V/Q/E/S/I/Y 30. C 31. C S 32. F Y/W/L/M 33. H 34. C 35. Q L/P/Y/I/V/M/A/T 36. V L/W/A/I/S/Y/M/D/K/H/N/R/T/F/C 37. C 38. F L 39. M T/Q/I/L/H/V/A/S 40. T K/N/H/Q/S/R/A/T/D 41. K 42. A G 43. L 44. G S/R 45. I T/V/L 46. S F/Y/V/I/C/P/L/H/R 47. Y H/N 48. G 49. R K 50. K R 51. K R 52. R W/Q 53. R K/S/G/T/Q/N 54. Q H/R/P/L/K/S 55. R Q/H 56. R H/P/Q/T/S 57. R G/S/T/N/K/A/P/Q 58. A T/P/S 59. H P/S/A/T 60. Q P/H/R/E/K/N/Y/L 61. N S/D/G/R/C/A/H 62. S N/G/Y/R/D/C/H 63. Q K/E/G/P/S/T/A/R 64. T D/A/I/N/S/P/G/V/H/E/L 65. H N/D/Y/R 66. Q K

DEFINITIONS

By the term “amino acid” is meant, for purposes of the specification and claims and in reference to the protein according to the present invention, to refer to a molecule that has at least one free amine group and at least one free carboxyl group and may further comprise one or more free chemical reactive group other than an amine or a carboxyl group (e.g., a hydroxyl, a sulfhydryl, etc). The amino acid may be a naturally occurring amino acid (e.g., L-amino acid and is depicted in this specification as a capital letter in the sequence), a non-naturally occurring amino acid (e.g., D-amino acid and is depicted in this specification as a small letter in the sequence), a synthetic amino acid, a modified amino acid, an amino acid derivative, an amino acid precursor, and a conservative substitution.

A person skilled in the art would know that the choice of amino acids incorporated into a protein will depend, in part, on the specific physical, chemical or biological characteristics required of the protein. Such characteristics are determined, in part, by determination of helicity and activity. For example, a skilled person would know that amino acids in a synthetic protein may be comprised of one or more of naturally occurring (L-) amino acid and non-naturally occurring (D-) amino acid.

A “conservative substitution” is used in this specification to mean one or more amino acids substitution in the sequence of the protein such that the protein still demonstrate the unexpected, improved biological activity. This includes substitutions of amino acids having substantially the same charge, size, hydrophilicity, and/or aromaticity as the amino acid replaced.

Nomenclature Used in this Specification

For the L-natural amino acids, as known in the art, the following abbreviations were used:

Symbol Name 3-Letter 1-Letter Alanine Ala A Arginine Arg R Asparagine Asn N Aspartic acid Asp D Cysteine Cys C Glutamic Acid Glu E Glutamine Gln Q Glycine Gly G Histidine His H Isoleucine Ile I Leucine Leu L Lysine Lys K Methionine Met M Phenylalanine Phe F Proline Pro P Serine Ser S Threonine Thr T Tryptophan Trp W Tyrosine Tyr Y Valine Val V

Furthermore part of the invention is the use of any of the above mentioned proteins wherein said protein comprises in addition another protein forming a fusion protein. Examples of such domains fused to HIV tat are transactivation domains (TAD) of host transcription factors such as NFkB or NFAT. By using the specific recruitment of Tat to the HIV LTR, additional transactivation domains are delivered in close proximity to the HIV promoter and surprisingly result in additional activation. Table 5 shows the increased activity of T66 linked to TADs from NFkB p65 and NFAT2. Another option would be to add a cell-targeting moiety to HIV tat such as anti-CD3 antibody or IL7 to target the transactivator more specifically to cells that are known to harbor latent HIV.

The T66 protein is used in a concentration of 1 μM to 10 μM, preferably of 2 μM to 5 μM.

After the use of the protein according to the invention HIV can be eradicated by addition of an antiviral agent such as a small molecule and/or antibody directed towards HIV in order to realize a cure of HIV.

Part of the invention is also a pharmaceutical composition comprising the protein above referenced and a pharmaceutically accepted carrier.

To the present invention also belongs a method for treating a subject with human immunodeficiency virus (HIV) comprising the steps of:

-   -   a) administering to said subject an effective amount of the         pharmaceutical composition comprising the protein according to         the invention and a pharmaceutically accepted carrier; and     -   b) administering to said subject an effective amount of one or         more anti-viral agent.

Experimental Part

TABLE 2 HIV LTR transactivation by Tat C-terminal deletion mutants. Tat variant % Tat72 activity 1-66 92.2 (±12.7) 1-64 77.2 (±10.8) 1-60 77.2 (±10.8) 1-57 40.2 (±2.3)  1-50 0.0 (NA) 

Activity is expressed in % with respect to the activity achieved by full length Tat72 exon-1 set to 100%. Shown data are mean values [n≧4] with indicated (standard deviation).

Tat-mediated transactivation was determined by triple plasmid transfection of HEK293 cells with pEF-T, a Tat expression plasmid, LTR-FLuc, a HIV LTR-controlled firefly luciferase reporter plasmid and pEF1-RLuc, a EF1α promoter driven Renilla luciferase reporter plasmid. Luciferase reporter activities were assessed 24 h post transfection using the Dual-Glo luciferase assay [Promega]. The measured HIV LTR luciferase data were normalized by Renilla luciferase data retrieved from the pEF1-RLuc plasmid. LTR activity is expressed as percentage of wild type exon-1 Tat72 activity.

TABLE 3 Titration of tat protein variants on latent HIV LTR-GFP reporter cell line. Tat [μg] 100 80 70 60 50 40 30 0 T72 93.7 93.8 88.8 76.3 60.4 47.2 18.6 1.2 T66 94.5 93.9 87.6 88.7 87.0 53.8 45.7 1.0 T60 93.3 95.8 95.2 92.1 87.0 33.4 28.5 1.1

MT4-LTR-GFP cells were incubated overnight with different Tat variants at the indicated concentration [μg/ml]. LTR activation was determined by flow cytometry.

TABLE 4 Ex vivo activation of CD4 cells with Tat protein T60, T66, and T86. % Activity (PMA/PHA) Tat Donor 1 Donor 2 Donor 3 Donor 4 Donor 5 T60 405/328 ND 213/196 ND ND/254 T66 838/680 1121/986 530/487 ND/479 ND/636 T86 ND ND ND ND/436 ND/408

Activation of latent HIV from primary CD4⁺ T cells by overnight incubation with different Tat proteins. Indicated numbers represent HIV activation in percentage to reference compounds PMA and PHA set to 100%. The shown % increase compared to PMA/PHA is statistically significant (p<0.01).

CD4⁺ T cells were isolated from 200 ml whole blood using CD4 microbeads (Miltenyi Biotec) according to manufacturer's protocol. Blood originates from HIV-infected individuals under long-term HAART with undetectable plasma virus. Ten to twenty replicates of cell pools plated at 1×10⁶ CD4⁺ T cells/well were incubated overnight with compounds or mock controls (DMSO/PBS). Total RNA was isolated from each replicate using the Magmax 96 Total RNA isolation kit (Ambion) following the manufacturer's protocol. Duplicate cDNA reactions were performed on each RNA replicate using SuperScript III First-Strand Synthesis kit (Invitrogen) according to the manufacturer's protocol. Quantitative real-time PCR (QPCR) was conducted on each cDNA applying gag-specific primers and the nucleic acid detection dye Sybr Green I [Invitrogen]. Standard curves were generated using cDNA synthesized from in vitro transcribed RNA. The detection limit of the QPCR assay was determined to be within 1-10 copies/reaction. Cycle threshold (ct) value≧40 were excluded from the analysis. The Wilcoxon rank sum test was used to calculate the statistical significance of the relative HIV-1 gag RNA copy number between different conditions.

TABLE 5 T66 fusion proteins result in increased activation when compared to T66. pEF-T ID FLUC RLUC FLUC_(norm) Fold % T66 T66 15437 267 37049 26 100 T66-NFK114 25480 380 42918 30 116 T66-NFAT2C 22614 304 47674 33 129 Cell control 1450 641 1448 1 4

Triple plasmid transfection of HEK293 cells with pEF-T (Tat expression plasmid), LTR-FLuc (HIV LTR-controlled firefly luciferase reporter plasmid) and pEF1-RLuc (EF1α promoter driven Renilla luciferase reporter plasmid). Luciferase reporter activities were assessed 24 h post transfection using the Dual-Glo luciferase assay [Promega]. The measured HIV LTR luciferase data were normalized by Renilla luciferase data collected from the co-transfected pEF1-RLuc signal. LTR activation is either expressed as fold increase over cell control or as percentage of T66 activity. 

1.-9. (canceled)
 10. An isolated protein having the amino acid sequence of the group consisting of: SEQ ID. NO: 1, SEQ ID. NO: 2 and SEQ ID. NO:
 3. 11. An isolated protein of claim 10, wherein the protein has the amino acid sequence of SEQ ID. NO:
 1. 12. An isolated protein of claim 10, wherein the protein has the amino acid sequence of SEQ ID. NO:
 2. 13. An isolated protein of claim 10, wherein the protein has the amino acid sequence of SEQ ID. NO:
 3. 14. A pharmaceutical composition, comprising the protein of claim
 10. 15. A pharmaceutical composition of claim 10, wherein the protein has the amino acid sequence of SEQ ID. NO:
 1. 16. A pharmaceutical composition of claim 10, wherein the protein has the amino acid sequence of SEQ ID. NO:
 2. 17. A pharmaceutical composition of claim 10, wherein the protein has the amino acid sequence of SEQ ID. NO:
 3. 18. A method for treating a subject with human immunodeficiency virus (HIV) comprising the steps of: a) administering to said subject an effective amount of the composition of claim 14; and b) administering to said subject an effective amount of one or more anti-viral agent.
 19. A method of treating a subject of claim 18, wherein the subject is administered an effective amount of the composition of claim
 15. 20. A method of treating a subject of claim 18, wherein the subject is administered an effective amount of the composition of claim
 16. 21. A method of treating a subject of claim 18, wherein the subject is administered an effective amount of the composition of claim
 17. 